Individual
AMBER GIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, LST
Contact information
Practice address
1375 E MILES AVE, HAYDEN, ID 83835-9251
(208) 653-5629
Mailing address
1375 E MILES AVE, HAYDEN, ID 83835-9251
(208) 653-5629
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MASG-788
ID
Other
Enumeration date
12/30/2013
Last updated
06/18/2014
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